Stop Loss Options

CareFirst can help protect your self-funded health plan clients in the event of catastrophic or higher than expected claims. Pairing CareFirst administrative services with CareFirst Stop Loss insurance provides employers a simple solution to manage their benefit plan – all from the name you know and trust.

Sample Costs
Specific Coverage (Individual Coverage) Aggregate Coverage
  • Coverage for groups with as few as 100 participants
  • Specific deductibles starting at $50,000
  • Standard 12-month contract terms including incurred and paid as well as run-in and run-out contracts
  • Aggregate benefit maximums up to $2,000,000
  • Automatic aggregate accommodation
  • Cash flow protection—automatic Stop Loss adjudication credited toward claims invoice for CareFirst administered group

Additional coverage options are also available.

If you are interested in receiving a Stop Loss quote, please provide the following information to your CareFirst broker sales representative:

  • Employees’ complete census in one Excel file, including:
    • Gender
    • Date of birth
    • Zip code
    • Coverage tier
    • Plan elections
  • Current benefit summaries or plan documents for all medical and pharmacy plans
  • Proposed benefits if they do not match current plan designs
  • Current renewal and prior year renewal with rates
  • Claims experience to include:
    • Monthly claims and enrollment for at least 6 months in the current year policy period and two prior policy periods
    • All large claims at 50% of the requested deductible (including medical and Rx) with diagnosis for at least 6 months in the current year policy period and two prior policy periods

To learn more about CareFirst Stop Loss download our fact sheet.